Authors: Cha YM et al.
Source: The Daily Dose — Friday, May 8, 2026
Coverage from the 2026 Annual Meeting presented by the International Anesthesia Research Society (IARS) and Society of Critical Care Anesthesiologists (SOCCA)
At the 2026 IARS/SOCCA Annual Meeting late-breaking perioperative medicine session, Duminda Wijeysundera presented findings from the FIT After Surgery study (Functional Improvement Trajectories After Surgery), a multicenter prospective cohort study examining long-term recovery outcomes in older adults undergoing major elective noncardiac surgery.
The study focused on adults 65 years of age and older and explored an increasingly important concept in perioperative medicine: functional recovery after surgery. Traditional perioperative outcome measures often emphasize mortality, complications, and hospital discharge timing, but these metrics do not fully capture whether patients regain independence, mobility, cognition, and quality of life after surgery.
The FIT After Surgery investigators therefore evaluated broader patient-centered outcomes including:
• Self-reported disability
• Medical complications
• Pain symptoms
• Depressive symptoms
• Decisional regret
The results highlighted the substantial long-term impact surgery can have on older adults.
New disability or death occurred in approximately:
• 1 in 6 patients at 6 months after surgery
• 1 in 5 patients at 1 year after surgery
Investigators also identified a nadir period of functional decline occurring approximately 3 to 6 months after surgery. Although some patients gradually improved afterward, many continued to experience persistent disability beyond that timeframe.
Several important risk factors for postoperative disability were identified.
Patient vulnerability factors included:
• Frailty
• Mobility limitations
• Cognitive impairment
Surgical risk factors included:
• Open surgical procedures
Contextual and social factors included:
• Recent smoking history
• Poor social support
The presentation emphasized that standard informed consent discussions frequently underrepresent these long-term functional risks. Older adults may prioritize independence, cognition, and functional recovery as much as — or even more than — short-term survival statistics.
The investigators suggested that future perioperative risk prediction tools should incorporate individualized assessments of frailty, cognitive status, mobility, and social support in addition to traditional surgical risk metrics.
These findings may have major implications for perioperative optimization programs, shared decision-making, prehabilitation strategies, and postoperative recovery planning in aging surgical populations.
Because these findings were presented during a conference late-breaking session, full peer-reviewed publication is still pending.
Key Points
• FIT After Surgery evaluated long-term functional recovery in adults age 65 and older undergoing major elective noncardiac surgery
• Traditional perioperative outcomes may fail to capture meaningful patient-centered recovery measures
• New disability or death occurred in 1 in 6 patients at 6 months and 1 in 5 patients at 1 year
• Functional decline appeared worst between 3 and 6 months after surgery
• Frailty, mobility limitations, cognitive impairment, smoking history, poor social support, and open surgery increased risk
• Investigators emphasized the need for more individualized perioperative risk prediction tools
• Findings may significantly impact informed consent and perioperative care planning for older adults
Thank you to IARS and SOCCA for allowing us to summarize and share these important perioperative medicine conference findings.